SENATOR MURPHY ANNOUNCES $19 MILLION INVESTMENT TO COMBAT HEROIN AND OPIOID EPIDEMIC IN HUDSON VALLEYLegislation is part of $213 million statewide investment package signed by Governor Cuomo

Long Island, NY – When the use of heroin and opioid began to increase dramatically across the Hudson Valley, Senator Terrence Murphy was the first elected official to call for legislation to stem the rising tide of what would become an epidemic. He took action, first by serving as Co-Chair of the State Senate’s Task Force on Heroin and Opioid Abuse and by passing legislation to promote prevention, treatment recovery and education to help citizens caught in the grip of addiction.

Senator Murphy’s diligent efforts came to fruition today when he stood alongside Governor Andrew Cuomo as the Governor signed legislation investing over $200 million to combat the plague of heroin and opioid dependency in New York State. The Mid-Hudson Valley will receive $19 million.

“Too many lives have been ruined by the influx of heroin and opioid invading our communities,” said Senator Murphy. “No one is immune to this epidemic. We now have the ammunition to fight for our children and our families. This increase in funding gives us the financial clout to empower our communities through enhanced prevention, treatment and recovery options.”

In 2016, the Governor signed into law a comprehensive plan first put forward by Senator Murphy’s task force to increase access to treatment, expand community prevention strategies, and limit the over-prescription of opioids in New York. Just last week, United States Senators Kirstin Gillibrand and John McCain introduced identical legislation on the federal level, proving the measures passed stand as a national model in America’s efforts to combat this terrible epidemic.

The FY 2018 Budget builds on this progress by investing over $200 million to support prevention, treatment and recovery programs targeted toward chemical dependency, residential service opportunities, and public awareness and education activities. The funding supports opioid treatment slots, 24/7 urgent access centers, community coalitions, family support navigators, peer engagement programs, adolescent clubhouses and community and outreach centers.

Overdose deaths involving all opioids continues to rise in New York. The number of opioid deaths in 2015 doubled compared to the number in 2010 and the number of heroin involved deaths in 2015 was five times of that in 2010. In addition, there has been a higher increase in opioid deaths between 2010 and 2015 outside of New York City, with sharper increase in heroin related deaths outside of NYC.

Since Senator Murphy arrived in Albany, a series of aggressive reforms to combat heroin and opioid addiction have been implemented, including:

Builds on Governor’s 2016 Legislation to Limit Over-Prescription and Eliminate Barriers to Treatment

Governor Andrew M. Cuomo today signed legislation investing over $200 million to combat the heroin and opioid epidemic in New York. In 2016, the Governor signed into law a comprehensive plan following the recommendations of the Heroin and Opioid Task Force, to increase access to treatment, expand community prevention strategies, and limit the over-prescription of opioids in New York. The FY 2018 Budget builds on this progress by investing over $200 million to support prevention, treatment and recovery programs targeted toward chemical dependency, residential service opportunities, and public awareness and education activities.

“We have made significant progress in combating the devastating heroin and opioid epidemic in New York, but this crisis continues to plague our communities and we must do everything in our power to combat each facet of this complex health emergency,” Governor Cuomo said. “This comprehensive investment addresses each component of heroin and opioid addiction – prevention, treatment, and recovery – to help individuals and families break this cycle of misery, save lives and create a stronger, healthier state for all.”

Overdose deaths involving all opioids continues to rise in New York. The number of opioid deaths in 2015 doubled compared to the number in 2010 and the number of heroin involved deaths in 2015 was five times of that in 2010. In addition, there has been a higher increase in opioid deaths between 2010 and 2015 outside of New York City, with sharper increase in heroin related deaths outside of NYC.

Given this epidemic, the FY 2018 Budget invests $213 million to address the heroin and opioid crisis in New York, representing an increase of over 100 percent from FY 2011. The investments include:

$145 million for community-based providers

$65 million for 8,000 residential treatment beds

$9 million for housing units

$41 million for opioid treatment programs

$21 million for outpatient services

$9 million for crisis/detox programs

$27 million for state-operated addiction treatment centers

$6 million for Naloxone kits and training

$25 million for expanded programs, including family support navigators, peer engagement and 24/7 urgent access centers

“This administration, under the leadership of Governor Cuomo, has taken aggressive action against heroin and opioid addiction,” Lieutenant Governor Kathy Hochul, Co-Chair of the Governor’s Task Force to Combat Heroin and Opioid Addiction, said. “The additional influx of funding provided in this Budget will ensure even more individuals, families and communities will get the help they need to fight this deadly epidemic. This plague has claimed too many lives across our state.”

“This comprehensive investment addresses each component of heroin and opioid addiction – prevention, treatment, and recovery – to help individuals and families break this cycle of misery, save lives and create a stronger, healthier state for all.”

Governor Andrew M. Cuomo

A regional breakdown of the FY 2018 Budget funding is available below:

Capital Region – $7 million

Central New York – $5 million

Finger Lakes – $12 million

Long Island – $23 million

Mid-Hudson Valley – $19 million

Mohawk Valley – $5 million

New York City – $94 million

North Country – $7 million

Southern Tier – $3 million

Western New York – $16 million

Governor Cuomo’s Previous Initiatives

Since 2014, Governor Cuomo has implemented a series of aggressive reforms to combat heroin and opioid addiction, including:

Limiting initial opioid prescriptions for acute pain from 30 to 7 days

Expanding insurance coverage for substance use disorder treatment

Increasing access and enhancing treatment capacity across the state, including a major expansion of opioid treatment and recovery services

Implementing the comprehensive I-STOP law to curb prescription drug abuse

Launching a public awareness and prevention campaign to inform New Yorkers about the dangers of heroin use and opioid misuse and the disease of addiction

Assembling a task force to propose initiatives to tackle the heroin and opioid epidemic

Dutchess County Sheriff Adrian “Butch” Anderson is hosting a fundraiser for End Overdose in the Harlem Valley (The Prevention Foundation Mid-Hudson Valley – Harlem Valley Coalition) Friday April 7, 7:30 – 11 pm at The Links at Union Vale. There will be a silent auction, food and drinks, and live music by “DJ of the Year” finalist Mike Alevras of HVE Associates.

“Opioid addiction is at epidemic proportion in the Unite States. Community coalitions like End Overdose in the Harlem Valley are working with local businesses, non-profits, hospitals, schools, law enforcement, and residents to make a difference in how this epidemic affects our communities, in eastern Dutchess County,” said Dutchess County Sheriff Adrian “Butch” Anderson. “Join us and help us raise money to take action and create change.”

Elaine Trumpetto, Executive Director CAPEDC

“We are in the midst of a public health epidemic-locally, regionally, statewide, nationally and globally,” said Elaine Trumpetto, Executive Director of CAPEDC. “Public health is always the beneficiary of education that builds awareness and supports informed decision making.”

According to the federal Drug Enforcement Administration (DEA), more than half of all drug overdose deaths nationwide were caused by opioids in 2014, and the Centers for Disease Control (CDC) says since 2000, the rate of deaths from drug overdoses has increased 137%, including a 200% increase in the rate of overdose deaths involving opioids (opioid pain relievers and heroin).

Tickets for the event are $40 per person or $70 a couple. Please RSVP to endoverdose@gmail.com or call The Links at Union Vale 845-223-1002.

Naloxone blocks or reverses the effects of opioid medication. (Seth Herald for NPR)

Aetna, one of the nation’s largest insurance companies, will remove a key barrier for patients seeking medication to treat opioid addiction. The change will take effect in March and apply to commercial plans, a company spokeswoman confirmed, and will make it the third major insurer to make the switch.

Specifically, Aetna will stop requiring doctors to seek approval before prescribing particular medications ― such as Suboxone ― that are used to mitigate withdrawal symptoms, and typically given along with steady counseling. The insurance practice, called “prior authorization,” can result in delays of hours to days in getting a prescription filled.

The change comes as addiction to opioids, which include heavy-duty painkillers and heroin, still sweeps the country. More than 33,000 people died from overdosing on these drugs in 2015, the most recent year for which statistics are available. And it puts Aetna in the company of Anthem and Cigna, which both recently dropped the prior authorization requirement for privately insured patients across the country. Anthem made the switch in January and Cigna this past fall.

Both companies took the step after facing investigation with New York’s attorney general, whose office was probing whether their coverage practices unfairly barred patients from needed treatment. They made this adjustment as part of larger settlements.

This KHN story also ran on NPR. It can be republished for free (details).

It sounds like just a technicality ― a brief delay before treatment. But addiction specialists say this red tape puts people’s ability to get well at risk. It gives them a window of time to change their minds or go into withdrawal symptoms, causing them to relapse.

“If someone shows up in your office and says, ‘I’m ready,’ and you can make it happen right then and there ― that’s great. If you say, ‘Come back tomorrow, or Thursday, or next week,’ there’s a good chance they’re not coming back,” said Josiah Rich, a professor of medicine and epidemiology at Brown University and doctor at Providence-based Miriam Hospital, who frequently treats patients with opioid addictions. “Those windows of opportunity present themselves. But they open and close.”

As these major carriers drop the requirement, treatment specialists hope a trend could be emerging in which these addiction meds become more easily available. In New York, for instance, the attorney general’s office will be following up with other carriers who still have prior authorization requirements, an office spokesperson said. The office would not specify which carriers it will next examine.

Meanwhile, though little research pinpoints precisely how widespread this coverage practice is for drugs that treat opioid addiction, experts say it’s a fairly common practice.

“Just think of any big health insurance company that hasn’t recently announced they’re doing away with this, and it’s a pretty safe bet they’ve got prior authorization in place,” said Andrew Kolodny, a Brandeis University senior scientist and the executive director of Physicians for Responsible Opioid Prescribing, an advocacy group.

How does the problem manifest? Take Boston Medical Center, located in a region that’s been particularly hard hit by opioid addiction. Doctors there wanted to launch an urgent care center focused on this patient population. Less than a year old, the program’s treated thousands of people.

But prior authorization requirements have been intense, said Traci Green, an associate professor at Boston University’s School of Medicine and deputy director of the hospital’s injury prevention center. To help people get needed care ― before it was too late ― the center hired a staffer devoted specifically to filling out all the related insurance paperwork.

“It was like, ‘This is insanity,’” Green said, adding that “navigating the insurance was a huge problem” for almost every patient.

But defenders of the requirement maintain that such controls have value. Insurance plans using prior authorization may view it as a safeguard when prescribing a potentially dangerous drug. “[It’s] not a tool to limit access. It’s a tool to ensure patients get the right care,” said Susan Cantrell, CEO of the Academy of Managed Care Pharmacy, a trade group.

Other large insurance carriers ― such as United Healthcare and Humana ― list on their drug formularies a prior authorization requirement for at least some if not all versions of anti-addiction medication. A spokesperson from Humana said the practice is used “to ensure appropriate use.”

Also, though, it is generally agreed that the practice is used to control the prescribing of expensive medications. Per dose, the cost of these drugs varies based on brand and precise formulation, but it can go as high as almost $500 for a 60-pack dose, which can last a month.

Regardless of intent, critics say, those extra forms and hoops do make it more difficult for patients in need to get these medications ― ultimately, they say, doing more harm than good.

“If you would like a physician to not do a particular treatment, put a prior authorization in front of it,” Rich said. “That’s what they’re used for.”

Meanwhile, addiction treatment advocates and health professionals are hoping to build on what they see as new momentum.

Earlier this month, the American Medical Association sent a letter to the National Association of Attorneys General, calling for increased attention to insurance plans that require prior authorization for Suboxone or other similar drugs.

Minnesota’s attorney general has written to health plans in the state, asking they end prior authorization for addiction treatment. New York has also heard from other states interested in tackling the issue, the attorney general spokesperson said. And another project, called Parity Track, is soliciting complaints from consumers.

They’re arguing based on a requirement that insurance plans, thanks to so-called “parity laws,” must cover addiction treatment, and cover it at the same level as they do other kinds of health care.

The prior authorization requirement “doesn’t meet the sniff test for parity,” said Corey Waller, an emergency physician who chairs the American Society of Addiction Medicine’s legislative advocacy committee. “It’s a first-line, Food and Drug Administration-approved therapy for a disease with a known mortality. Every other disease with a known mortality ― the first-line drugs are available right away.”

But the justification for legal cases like New York’s could get weaker. The 2010 health law, which lawmakers are working to repeal, included requirements that mental health and addiction treatment be considered an “essential health benefit.” If that disappears, robust coverage for addiction could be less widely available, several noted.

Meanwhile, the stakes are substantial, Rich said. He recalled a patient who was taking a version of buprenorphine ― the active ingredient in Suboxone ― who had a brief relapse with heroin. That led to complications in the paperwork for renewing his prescription for treatment.

“Now he’s out of the office, in the street, using more,” Rich said of that case. “Incumbent upon [effective treatment] is the ability to get people started right away. If there’s prior authorization? It’s infuriating.”